| ACL Reconstruction (Arthroscopic) | $4,230$258$14k | $10,249 | $7,679 |
| Allergy Skin Testing | $7$4$258 | $1,846 | $2,637 |
| Basic Metabolic Panel | $20$12$258 | $85 | $122 |
| Bone Marrow Biopsy | $1,419$80$3.1k | $2,920 | $4,171 |
| Breast Biopsy (Ultrasound-guided) | $1,953$165$4.3k | $2,230 | $3,185 |
| Bunion Correction Surgery | $4,230$258$7.6k | $12,499 | $17,856 |
| Cardiac Ablation for Atrial Fibrillation | $9,097$258$20k | $24,887 | $35,553 |
| Cardiac Catheterization (Left Heart) | $7,138$258$23k | $6,381 | $9,115 |
| Carpal Tunnel Release Surgery | $3,565$258$4.8k | $5,697 | $7,017 |
| Cataract Surgery with Lens Implant | $6,869$258$9.1k | $4,256 | $6,080 |
| Cervical Spinal Fusion (Anterior) | $7,726$258$17k | $24,817 | $35,453 |
| Chemotherapy Infusion (First Hour) | $421$140$421 | $753 | $1,075 |
| Chest X-ray (2 Views) | $258$23$258 | $257 | $367 |
| Colonoscopy with Biopsy | $3,553$258$4.7k | $3,616 | $4,141 |
| Complete Abdominal Ultrasound | $132$71$258 | $559 | $798 |
| Complete Blood Count (CBC) with Differential | $18$11$258 | $62 | $88 |
| Comprehensive Metabolic Panel | $24$15$258 | $97 | $138 |
| Coronary Angioplasty with Stent | $7,726$258$17k | $19,373 | $27,675 |
| Critical Care, First Hour | $1,419$229$3.4k | $4,408 | $6,297 |
| CT Abdomen and Pelvis with Contrast | $490$258$901 | $2,323 | $3,319 |
| CT Cardiac Calcium Scoring | $94$50$258 | $92 | $132 |
| CT Chest without Contrast | $250$156$585 | $1,383 | $1,976 |
| CT Head without Contrast | $200$113$417 | $1,285 | $1,835 |
| DEXA Bone Density Scan | $120$46$258 | $291 | $415 |
| Diagnostic Colonoscopy | $3,553$258$4.7k | $3,802 | $5,432 |
| Diagnostic Mammogram (Both Breasts) | $258$104$339 | $488 | $697 |
| Ear Tube Placement (Tympanostomy) | $3,632$173$4.8k | $2,681 | $3,732 |
| Echocardiogram (Complete with Doppler) | $1,953$159$3.1k | $869 | $1,242 |
| Emergency Room Visit (Level 3) | $1,344$63$1.4k | $1,509 | $2,155 |
| Group Therapy Session | $258$24$909 | $294 | $420 |
| Hemoglobin A1c (Diabetes Test) | $22$14$258 | $105 | $150 |
| HIV Antibody Test | $21$13$258 | $49 | $70 |
| Home Sleep Study | $185$121$258 | $2,002 | $2,860 |
| Individual Therapy Session (45 Minutes) | $258$24$909 | $262 | $374 |
| Inguinal Hernia Repair (Open) | $5,075$258$7.6k | $8,816 | $12,594 |
| Initial Hospital Admission (Level 1) | $725$87$2.4k | $2,237 | $3,196 |
| Initial Psychiatric Diagnostic Evaluation | $258$24$909 | $236 | $337 |
| Initial Psychiatric Evaluation with Medication Management | $258$24$909 | $236 | $337 |
| Intensity-modulated Radiation Therapy (IMRT) Treatment | $697$258$1.3k | $3,377 | $4,824 |
| IUD Insertion | $258$80$1.4k | $164 | $118 |
| IUD Removal | $258$88$1.4k | $786 | $562 |
| Knee Arthroscopy with Meniscectomy | $5,114$258$7.6k | $6,900 | $9,386 |
| Laparoscopic Appendectomy | $7,138$258$14k | $7,409 | $10,584 |
| Laparoscopic Gallbladder Removal | $7,138$258$14k | $17,727 | $25,324 |
| Laparoscopic Tubal Ligation | $5,769$258$14k | $6,093 | $8,704 |
| Lipid Panel (Cholesterol Test) | $30$19$258 | $117 | $167 |
| Lumbar Epidural Steroid Injection | $1,953$101$3.1k | $958 | $1,368 |
| Lumbar Puncture (Spinal Tap) | $2,223$101$3.1k | $1,283 | $1,833 |
| Lumbar Spinal Fusion (Posterior) | $9,481$258$26k | $7,965 | $11,378 |
| Lumpectomy (Partial Mastectomy) | $3,923$258$7.6k | $10,786 | $12,220 |
| MRI Abdomen with and without Contrast | $882$258$2.1k | $2,672 | $3,817 |
| MRI Brain with and without Contrast | $924$258$2.6k | $1,945 | $2,779 |
| MRI Brain with Contrast | $529$258$1.3k | $2,372 | $3,388 |
| MRI Brain without Contrast | $421$232$1.2k | $1,418 | $2,026 |
| MRI Cervical Spine (Neck) without Contrast | $416$223$1.2k | $1,457 | $2,081 |
| MRI Knee without Contrast | $416$251$1.2k | $1,504 | $2,148 |
| MRI Lower Back (Lumbar Spine) without Contrast | $462$223$1.3k | $1,532 | $2,188 |
| MRI Thoracic Spine (Mid-back) without Contrast | $445$223$1.2k | $2,010 | $2,872 |
| Newborn Circumcision | $2,223$146$4.7k | $3,587 | $5,124 |
| Nuclear Cardiac Stress Test | $622$258$1.1k | $2,486 | $3,552 |
| Office Visit, Established Patient (Level 3) | $186$82$258 | $215 | $307 |
| Office Visit, New Patient (Level 3) | $186$100$258 | $266 | $380 |
| Pacemaker Insertion (Dual Chamber) | $5,152$258$9.1k | $6,201 | $8,859 |
| PET/CT Scan, Whole Body | $5,173$258$6.3k | $3,532 | $5,046 |
| Pregnancy Ultrasound (Second or Third Trimester) | $141$75$258 | $603 | $861 |
| Prostate Biopsy | $3,553$194$4.7k | $5,169 | $7,384 |
| PSA Prostate Cancer Screening | $40$27$258 | $140 | $200 |
| Pulmonary Function Test with Bronchodilator | $90$33$258 | $362 | $517 |
| Rotator Cuff Repair (Arthroscopic) | $6,220$258$14k | $24,583 | $34,133 |
| Screening Mammogram | $258$107$280 | $267 | $381 |
| Septoplasty (Deviated Septum Repair) | $4,758$186$7.6k | $6,860 | $7,995 |
| Sinus Surgery (Endoscopic, with Tissue Removal) | $5,341$186$12k | $10,648 | $15,212 |
| Skin Biopsy (Tangential) | $69$60$996 | $2,676 | $3,824 |
| Skin Lesion Removal (Benign, up to 0.5 cm) | $258$93$3.1k | $2,587 | $2,588 |
| Sleep Study (In-lab Polysomnography) | $598$258$1.0k | $2,606 | $3,723 |
| Spinal Cord Stimulator Trial | $3,553$258$7.7k | $7,210 | $2,838 |
| Spirometry (Breathing Test) | $52$19$258 | $295 | $422 |
| Tonsillectomy and Adenoidectomy (Age 12 and Over) | $4,817$258$6.7k | $4,570 | $6,528 |
| Tonsillectomy and Adenoidectomy (Under Age 12) | $3,632$258$4.8k | $3,996 | $5,708 |
| Total Hip Replacement | $8,650$258$17k | $21,952 | $31,361 |
| Total Knee Replacement | $7,138$258$14k | $27,753 | $39,647 |
| Total Mastectomy | $5,075$258$12k | $28,841 | $41,201 |
| TSH Thyroid Function Test | $39$24$258 | $127 | $182 |
| TURP (Transurethral Prostate Resection) | $5,075$258$12k | $7,111 | $10,158 |
| Upper GI Endoscopy (EGD) | $2,351$198$4.3k | $2,778 | $3,969 |
| Urinalysis with Microscopy | $7$5$258 | $34 | $49 |
| Vaginal Hysterectomy | $6,107$258$14k | $12,525 | $17,893 |
| Vasectomy | $3,131$235$4.8k | $5,986 | $8,552 |
| Vitamin D Blood Test | $67$43$258 | $288 | $411 |